Völz Daniela, Grabenweger Reinhard, Best Megan C, Hau Peter, Jones Kate F, Linker Ralf, Paal Piret, Bumes Elisabeth
Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany.
Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria.
Neurooncol Pract. 2024 Dec 19;12(3):520-530. doi: 10.1093/nop/npae120. eCollection 2025 Jun.
Patients with primary malignant brain tumors suffer from symptoms of both neoplastic and neurological disease, resulting in a limited prognosis and high symptomatic burden, including aphasia and mental deterioration. Thus, special spiritual care needs arise for these patients, which may be challenging. We explore spiritual tools that neurological and neurosurgical healthcare workers use when confronted with spiritual distress of their patients.
A vignette-based, cross-sectional, multicenter online survey was conducted to collect qualitative data. In total, 143 nurses and physicians working on 41 neurological and neurosurgical units in Bavarian hospitals participated and their self-reported behavior was analyzed using reflexive thematic analysis.
A total of 5 themes regarding the spiritual tools implemented by nurses and physicians in neuro-oncology were generated: (1) from physical to spiritual care, (2) feeling togetherness between the words, (3) listening to each other: one word at a time, (4) away from the dooming "why"-escaping the thought spirals, and (5) taking life back into one's own hands. These themes represent a spectrum including nonverbal tools like building a physical connection, allowing for emotional connection, and active listening. The verbal approach focuses on conversation strategies to relieve patients of guilt, facilitate spiritual discussions at the end-of-life, and communicate the diagnosis, prognosis, and treatment to strengthen self-efficacy.
Verbal, nonverbal, and holistic approaches to spiritual care in neuro-oncology were identified and can be used to develop a spiritual care toolbox for nurses and physicians in neuro-oncology, given the unique needs of patients with primary malignant brain tumors.
原发性恶性脑肿瘤患者同时遭受肿瘤性疾病和神经性疾病的症状折磨，导致预后有限且症状负担沉重，包括失语和精神衰退。因此，这些患者有特殊的精神护理需求，而这可能具有挑战性。我们探讨神经科和神经外科医护人员在面对患者的精神痛苦时所使用的精神护理方法。
开展了一项基于案例的横断面多中心在线调查，以收集定性数据。巴伐利亚医院41个神经科和神经外科科室的143名护士和医生参与了调查，并使用反思性主题分析法对他们自我报告的行为进行了分析。
共产生了5个关于神经肿瘤学中护士和医生所采用的精神护理方法的主题：（1）从身体护理到精神护理；（2）感受言语间的亲密感；（3）相互倾听：一次一个词；（4）远离注定的“为什么”——摆脱思维螺旋；（5）将生活掌控在自己手中。这些主题代表了一个范围，包括建立身体联系、实现情感联系和积极倾听等非语言方法。语言方法侧重于对话策略，以减轻患者的内疚感，促进临终时的精神讨论，并传达诊断、预后和治疗信息以增强自我效能感。
鉴于原发性恶性脑肿瘤患者的独特需求，确定了神经肿瘤学中精神护理的语言、非语言和整体方法，可用于为神经肿瘤学中的护士和医生开发一个精神护理工具箱。
